U.S. patent application number 17/599882 was filed with the patent office on 2022-06-23 for incubation system for liquid-based incubation of prematurely born infants.
The applicant listed for this patent is TECHNISCHE UNIVERSITEIT EINDHOVEN. Invention is credited to Franciscus Leonardus Marie DELBRESSINE, Laurentius Michiel Gerardus FEIJS, Swan Gie OEI, Franciscus Nicolaas VAN DE VOSSE, Marieke Beatrijs VAN DER HOUT-VAN DER JAGT, Myrthe VAN DER VEN.
Application Number | 20220192909 17/599882 |
Document ID | / |
Family ID | 1000006258460 |
Filed Date | 2022-06-23 |
United States Patent
Application |
20220192909 |
Kind Code |
A1 |
OEI; Swan Gie ; et
al. |
June 23, 2022 |
INCUBATION SYSTEM FOR LIQUID-BASED INCUBATION OF PREMATURELY BORN
INFANTS
Abstract
The present invention relates to an incubation system for
liquid-based incubation of prematurely born infants, comprising:
--an inner chamber forming an amniotic basin comprising amniotic
fluid, said basin being configured for holding said infant and
being made from a flexible material configured for expanding said
inner chamber volume in correspondence with the growth of said
infant; --an outer chamber enclosing said inner chamber and
comprising a temperature regulation fluid, --a fetal connection
port, arranged for connecting with the umbilical cord of said
infant, said umbilical cord providing a port in said inner chamber
to said infant for providing dialyzation and nutrition compounds to
said infant via said umbilical cord; --a fetal control unit,
connected to said fetal connection port for control of said
dialyzation and control of said provided nutrition by monitoring
and controlling one or more of a pressure, flow and temperature
thereof; an amniotic fluid circulation unit, arranged for
connecting with an inlet/outlet port of said inner chamber and
comprising a pump for circulating said amniotic fluid from said
inner chamber and through a purification system located outside
said inner chamber; and --a temperature regulation fluid control
unit, arranged for connecting with an inlet/outlet port of said
outer chamber and comprising a pump for circulating said
temperature regulation fluid from said outer chamber and through a
heat exchanger system located outside said inner chamber.
Inventors: |
OEI; Swan Gie; (EINDHOVEN,
NL) ; VAN DE VOSSE; Franciscus Nicolaas; (EINDHOVEN,
NL) ; FEIJS; Laurentius Michiel Gerardus; (EINDHOVEN,
NL) ; VAN DER HOUT-VAN DER JAGT; Marieke Beatrijs;
(EINDHOVEN, NL) ; VAN DER VEN; Myrthe; (EINDHOVEN,
NL) ; DELBRESSINE; Franciscus Leonardus Marie;
(EINDHOVEN, NL) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
TECHNISCHE UNIVERSITEIT EINDHOVEN |
EINDHOVEN |
|
NL |
|
|
Family ID: |
1000006258460 |
Appl. No.: |
17/599882 |
Filed: |
March 30, 2020 |
PCT Filed: |
March 30, 2020 |
PCT NO: |
PCT/EP2020/059012 |
371 Date: |
September 29, 2021 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
62826718 |
Mar 29, 2019 |
|
|
|
Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61M 2240/00 20130101;
A01N 1/0247 20130101; A61G 11/00 20130101 |
International
Class: |
A61G 11/00 20060101
A61G011/00; A01N 1/02 20060101 A01N001/02 |
Claims
1-11. (canceled)
12. An incubation system for liquid-based incubation of prematurely
born infants, comprising: an inner chamber forming an amniotic
basin comprising amniotic fluid, the amniotic basin configured to
an infant and made from a flexible material configured to expand an
inner chamber volume in correspondence with growth of the infant;
an outer chamber enclosing the inner chamber, the outer chamber
comprising a temperature regulation fluid; a fetal connection port
configured to connect with the umbilical cord of the infant, the
umbilical cord providing a port in the inner chamber to the infant
to provide dialyzation and nutrition compounds to the infant via
the umbilical cord; a fetal control unit coupled to the fetal
connection port to control the dialyzation and provided nutrition
by monitoring and controlling one or more of a pressure, flow and
temperature thereof; an amniotic fluid circulation unit configured
to connect with an inlet/outlet port of the inner chamber, the
amniotic fluid circulation unit comprising a pump configured to
circulate the amniotic fluid from the inner chamber and through a
purification system located outside of the inner chamber; and a
temperature regulation fluid control unit configured to connect
with an inlet/outlet port of the outer chamber, the temperature
regulation fluid control unit comprising a pump configured to
circulate the temperature regulation fluid from the outer chamber
and through a heat exchanger system located outside of the inner
chamber.
13. The incubation system according to claim 12, wherein the
amniotic fluid circulation unit comprises a UV light source.
14. The incubation system according to claim 13, wherein the
amniotic fluid circulation unit comprises at least one sensor
configured to purify the amniotic fluid.
15. The incubation system according to claim 12, wherein the
amniotic fluid circulation unit further comprises an inlet port
configured to introduce nutrients and water into the amniotic
fluid.
16. The incubation system according to claim 12, further comprising
at least one stimulation device disposed within or attached to the
outer chamber.
17. The incubation system according to claim 16, wherein the at
least one stimulation device comprises at least one of an auditory
stimulation device, a visual stimulation device, and a tactile
stimulation device.
18. The incubation system according to claim 12, further comprising
at least one sensor disposed within or attached to the outer
chamber.
19. The incubation system according to claim 18, wherein the at
least one sensor comprises at least one of a microfluidic device
and a capacitive sensor.
20. The incubation system according to claim 18, wherein the at
least one sensor is selected from the group including a camera, an
ultrasound imaging device, an electrocardiograph (ECG), an
electroencephalograph (EEG), a tactile sensor device, a chemical
analysis device for blood and/or amniotic fluid, and combinations
thereof.
21. The incubation system according to claim 12, further comprising
an extra corporeal membrane oxygenation unit (ECMO).
22. The incubation system according to claim 12, further comprising
an inlet port assembly for fluids configured to connect with the
umbilical cord of the infant.
Description
TECHNICAL FIELD
[0001] The present invention relates to an incubation system for
liquid-based incubation of prematurely born infants.
BACKGROUND
[0002] After birth, new-borns experience a transition from
intra-uterine to extra-uterine life. This normally leads to
physiological changes to the circulatory and respiratory systems.
For extremely prematurely born infants, i.e. below the 28th week of
gestation, their physiologic development is not ready to undergo
these changes. The transition is then often complicated by a
variety of sudden incidents, including cord clamping, heat loss
from immature skin, the necessity of respiratory support, and
delayed circulatory changes. Consequently, despite the promising
outcome provided by advances in the use of neonatal intensive care
units (NICU), still too many of extremely premature but viable
infants will suffer permanent health complications.
[0003] Prior to birth, "fetal life support" is provided mainly
through the placenta, a shared organ between mother and child. The
placenta serves not only as lung and kidney, but also provides
nutrition. Consequently, birth inevitably initiates the transition
from fetal to neonatal physiology, regardless of fetal maturity.
Hence the placental functions must be accounted for by either the
infant or life-support systems such as mechanical ventilation and
e.g. parenteral feeding. Although current intensive neonatal care
is provided in a high-tech setting to mitigate the consequences of
this transition as best as possible, current incubators remain a
relatively hostile environment. Indeed, mechanical ventilation in
premature infants accounts for a large portion of long-term
morbidity. Hence, for preterm born infants the main problem is a
too early transition to neonatal physiology.
[0004] The cardiorespiratory changes after birth are initiated by
the first breath and by the clamping of the umbilical cord, i.e.
the disconnection with the placental circulation. The latter can be
delayed, but the very strong reflex to breathe after birth cannot
be easily suppressed. Once the lung cavities have filled with air,
the transition cannot be reversed, and the premature infant is
dependent on life support.
[0005] For viable fetuses at risk of imminent preterm birth, these
complications might be prevented by transferring them to an
artificial womb, i.e. a similar environment as in-utero. The fetal
cardiorespiratory physiology will be preserved in this liquid-based
incubator, with the goal to delay and ease the transition to
extra-uterine life.
[0006] Partridge et al. disclose in Semin Fetal Neonatal Med. 2017
December; 22(6):404-409 an extrauterine environment for neonatal
development.
[0007] Usuda et al. disclose in Am J Obstet Gynecol. 2017 October;
217(4):457.e1-457.e13 an ex vivo uterine environment therapy
platform to eliminate fetal infection and inflammation, while
simultaneously extending the duration of hemodynamically stable ex
vivo uterine environment therapy to 1 week.
[0008] Partridge et al. disclose in Nat Commun. 2017 Apr. 25;
8:15112 an extra-uterine system to physiologically support the
extreme premature lamb.
[0009] The known extra-uterine systems are aimed mainly at the
survival of the extreme premature infant, and not at providing a
complete mimic of the womb environment.
SUMMARY
[0010] It is an object of the present invention to provide an
improved incubation system for incubation of prematurely born
infants, specifically a liquid-based incubation system.
[0011] It is a further object of the present invention to provide
an improved incubation system for liquid-based incubation of
prematurely born infants.
[0012] At least one of these objects is achieved by an incubation
system for liquid-based incubation of prematurely born infants,
comprising: [0013] an inner chamber forming an amniotic basin
comprising amniotic fluid, said basin being configured for holding
said infant and being made from a flexible material configured for
expanding said inner chamber volume in correspondence with the
growth of said infant; [0014] an outer chamber enclosing said inner
chamber and comprising a temperature regulation fluid, [0015] a
fetal connection port, arranged for connecting with the umbilical
cord of said infant, said umbilical cord providing a port in said
inner chamber to said infant for providing dialyzation and
nutrition compounds to said infant via said umbilical cord; [0016]
a fetal control unit, connected to said fetal connection port for
control of said dialyzation and control of said provided nutrition
by monitoring and controlling one or more of a pressure, flow and
temperature thereof; [0017] an amniotic fluid circulation unit,
arranged for connecting with an inlet/outlet port of said inner
chamber and comprising a pump for circulating said amniotic fluid
from said inner chamber and through a purification system located
outside said inner chamber; [0018] a temperature regulation fluid
control unit, arranged for connecting with an inlet/outlet port of
said outer chamber and comprising a pump for circulating said
temperature regulation fluid from said outer chamber and through a
heat exchanger system located outside said inner chamber.
[0019] The incubation system according to the present invention
serves as an artificial womb for prematurely born infants. It
emphasizes the natural functions of the physiological womb.
List of Definitions
[0020] The following definitions are used in the present
description and claims to define the stated subject matter. Other
terms not cited below are meant to have the generally accepted
meaning in the field.
[0021] "Fetal" or "fetal" as used in the present description means:
Related to the fetus or infant to be incubated in the system
according to the present invention. The infant is technically born
at the moment of leaving the maternal uterus, but due to the
incubation system according to the present invention it is not
fully transitioning into extrauterine life. The infant remains in
fetal stage, its physiological function and behaviour being
identical to that in the womb. Therefore, the term fetal is also
used in connection with the prematurely born infant for which the
system according to the invention is developed.
[0022] "Infant" as used in the present description means: a
recently born child, newborn or neonate, a baby. The term infant
may also include a fetus. This term can refer to a human baby, but
also the juveniles of other organisms. Preferably, the infant is a
human baby.
[0023] "Preterm", "premature birth" or "prematurely born" as used
in the present description relates to the birth of a baby before
full development of the fetus. When the baby is a human baby, this
generally means that a birth at fewer than 37 weeks' gestational
age, as opposed to the usual about 40 weeks.
[0024] "Amniotic fluid" or "AF" as used in the present description
means: the protective liquid contained by the amniotic sac. The
fluid serves as a cushion for the growing fetus, but also serves to
facilitate the exchange of nutrients, water, and biochemical
products. In relation to the present invention, the fluid present
in the inner chamber of the incubation system is also called
amniotic fluid. This fluid can be an artificially made composition.
The AF used in the incubation system of the invention may for
instance comprise water, electrolytes, proteins, carbohydrates,
lipids and phospholipids, and urea.
[0025] "Nutrition compounds" or "nutrients" as used in the present
description means: compounds or substances that are used by the
infant to survive and to grow and develop. These nutrients are
supplied to the infant in the incubation system of the present
invention via the umbilical cord and/or via the amniotic fluid.
[0026] "Extracorporeal membrane oxygenation" (ECMO) or
"extracorporeal life support" (ECLS) as used in the present
description means an extracorporeal technique of providing
prolonged cardiac and respiratory support to persons by providing
an adequate amount of gas exchange or perfusion to sustain life. In
the present invention, the ECMO is not used to provide gas to the
lungs, but oxygen may be provided via an oxygenator to the blood
re-entering the umbilical circulation to the infant.
BRIEF DESCRIPTION OF DRAWINGS
[0027] The present invention is described hereinafter with
reference to the accompanying drawings in which embodiments of the
present invention are shown and in which like reference numbers
indicate the same or similar elements.
[0028] FIG. 1 schematically shows a first embodiment of the system
according to the present invention, in use.
[0029] FIG. 2 schematically shows a second embodiment of the system
according to the present invention.
[0030] FIG. 3 schematically shows a third embodiment of the system
according to the present invention.
[0031] FIG. 4 schematically shows a fourth embodiment of the system
according to the present invention.
[0032] FIG. 5 shows a schematic view of the system for incubation
according to the invention.
DETAILED DESCRIPTION OF DRAWINGS
[0033] FIG. 1 shows an inner chamber 150, an outer chamber 140, a
fetal connection port 110, a fetal control unit 160, an amniotic
fluid circulation unit 130 and a temperature regulation fluid
control unit 120.
[0034] The inner chamber 150 forms an amniotic basin comprising
amniotic fluid. The basin is configured for holding an infant and
being made from a flexible material configured for expanding the
inner chamber volume in correspondence with the growth of the
infant.
[0035] The inner chamber (artificial womb) stretches with infant
growth, such that the infant has little perception of the
differences between the real and artificial womb. A flexible
material womb is designed to minimalize the number of transfers of
the infant on the one hand, and on the other hand to give a
realistic tactile feedback to the infant, which is expected to be
beneficial for normal limb/muscle development.
[0036] The outer chamber 140 encloses said inner chamber and
comprising a temperature regulation fluid.
[0037] The temperature regulation fluid may comprise or consist of
water.
[0038] The system comprises sensors 171, 172 inside or attached to
the outer chamber. Sensors appear linked to the inner chamber. All
sensors 171, 172 correspond to the function indicated next to the
sensor. They may include microfluidic device and/or a capacitive
sensors. Examples or sensors that can be present are a camera (360
degrees view), ultrasound imaging device, electrocardiograph (ECG),
electroencephalograph (EEG), tactile sensor device to monitor e.g.
breathing movements, chemical analysis device for blood and/or
amniotic fluid to monitor nutrition, respiration and kidney
function.
[0039] This tailored monitoring can be used to assess fetal growth
and well-being, in order to fine-tune the life-support functions of
the system on the one hand, and guide decision-making on the other
hand.
[0040] The system may comprise one or more stimulation devices
inside or attached to the outer chamber. These devices may include
auditory stimulation devices, visual stimulation devices and
tactile stimulation devices. The stimuli can be applied without the
actual presence of the mother and other family members, through
external applied movements on the system; audio speakers to play
sounds, and controlled lighting to mimic the diurnal rhythm. This
is a chamber-inside-chamber design: the inner chamber mimics the
womb, the outer chamber is to apply the auditory, visual and
tactile stimuli in a controlled environment (in the respective
figures, see text associated with outer chamber). The outer chamber
is equipped with temperature control (see heating element in
respective figures), although primary temperature control will take
place through the blood temperature regulation of the blood in the
placental circulation. The inner chamber contains amniotic fluid
that is constantly refreshed to prevent infection.
[0041] The inner chamber is a representation of the womb, while the
outer chamber allows for local stimuli, measurement devices, etc.
specific for this infant (this can be seen as a representation of
the mother/maternal environment). As each infant has its own inner
and outer chamber, stimuli can be individualized.
[0042] The temperature regulation fluid control unit 120 is
arranged for connecting with an inlet/outlet port of the outer
chamber and comprises a pump for circulating the temperature
regulation fluid from the outer chamber and through a heat
exchanger system located outside the inner chamber.
[0043] There is a heating element provided connected to the outer
chamber, which serves to heat the temperature regulation fluid,
which may be water, such that there is a constant body temperature
of the outer chamber, and thereby of the inner chamber. It is safer
to control the temperature of the outer than of the inner
chamber.
[0044] There is a pump provided connected to the outer chamber,
which serves to create a constant flow of water to be heated, and
thus a constant temperature of the outer chamber.
[0045] The amniotic fluid circulation unit 130 is arranged for
connecting with an inlet/outlet port of the inner chamber and
comprising a pump for circulating said amniotic fluid from the
inner chamber and through a purification system located outside the
inner chamber.
[0046] There is a pump provided connected to the inner chamber,
which serves to create a constant flow of amniotic fluid (AF) for
refreshing and filtering.
[0047] There is a membrane purification system provided, which
serves to clear the AF from any compounds that should not be
present in AF.
[0048] The amniotic fluid circulation unit comprises a UV light
source, as one or more sensors arranged for purification of the AF.
The source of UV-lightserves to kill all potential bacteria present
in AF. There are sensors provided which appear to be connected to
the UV, which serve to check the level of purification and killing
of bacteria.
[0049] The amniotic fluid circulation unit comprises an inlet port
to introduce nutrients and water into the amniotic fluid.
[0050] The sensors next to the label `supply for nutrients &
water supply) monitor the nutrition level in the amniotic
fluid.
[0051] The fetal connection port 110 is arranged for connecting
with the umbilical cord of the infant. The umbilical cord provides
a port in the inner chamber to the infant for providing dialyzation
and nutrition compounds to the infant via the umbilical cord. The
port may also be for providing oxygen and/or medication.
[0052] The umbilical cord connects the baby to the fetal
circulation.
[0053] The fetal control unit is connected to the fetal connection
port for control of said dialyzation and control of the provided
nutrition by monitoring and controlling one or more of a pressure,
flow and temperature thereof.
[0054] The fetal control unit comprises a placenta circulation
block which relationship with the fetal circulation is similar as
in real situation: only through the umbilical cord (intact
physiological circulation).
[0055] The fetal control unit comprises an inlet port assembly for
fluids, arranged for connecting with the umbilical cord of said
infant. There are components for IV fluids and medications
provided, linked to the artificial placenta circulation block, to
deliver fluids and medications directly via the placenta side.
[0056] There are monitor, pressure, flow and temperature blocks
provided, all linked to the artificial placenta circulation block.
The monitor provides information on blood pressure, blood flow, and
blood temperature of the placental circulation (i.e. maternal
side). Pressure, flow and temperature involve both sensors
connected to the blood in the umbilical cord or to the fetal
control unit, and regulators in the fetal control unit.
[0057] The fetal control unit comprising an extra corporeal
membrane oxygenation unit (ECMO). The provided O.sub.2 meter is
connected to the artificial placenta circulation block. The
function of the O.sub.2 meter is to measure oxygen level in the
blood, in order to regulate oxygen supply within physiological
range. The regulation is done with a gas mixer, connected to a tank
with O.sub.2 and a tank with air.
[0058] There is a dialysis unit provided connected to the placental
circulation. There is a bloodthinner added to the blood, a filter
for dialysis with a waste drain (left side) and inlet (right side)
for treated water, and a bubble trap.
[0059] FIG. 2 schematically shows a second embodiment of the system
according to the present invention.
[0060] This embodiment is similar to the first embodiment, but uses
a donor placenta. Hence, no ECMO is required. In addition, there
the system comprises an additional inlet port assembly for fluids,
arranged for connecting with the umbilical cord of said infant.
There are components for IV fluids and medications provided, linked
to the fetal circulation block, to deliver fluids and medications
directly into the fetal circulation. Some medication and fluids
should be delivered via the placenta side, other directly into the
fetal circulation.
[0061] There is also a further block provided on the left-hand of
the schematic figure which includes: monitor, pressure, flow and
temperature. This block also appears to be connected to the fetal
circulation block and the artificial placenta circulation block.
Their function is the same as described for the monitor, pressure,
flow and temperature of the placental monitor, but now for the
fetal circulation.
[0062] There is no dialysis unit. This function is taken care of by
the placenta, which may be a donor placenta or an artificial
placenta.
[0063] FIG. 3 schematically shows a third embodiment of the system
according to the present invention.
[0064] This embodiment is similar to the second embodiment, but
uses an artificial placenta. Therefore, it has a pump in an
artificial placenta circulation block, which serves to create a
blood flow in the placenta circulation. Normally, the maternal
heart would take care of this, but this is not the case in an
isolated placenta.
[0065] FIG. 4 schematically shows a fourth embodiment of the system
according to the present invention.
[0066] This embodiment is similar to the third embodiment. An
additional component is provided between the pump connected to the
inner chamber and the membranes purification system, for total
liquid ventilation. This serves to ventilate O.sub.2 and CO.sub.2.
Via this ventilation the infant also gets O.sub.2 via the amniotic
fluid and the CO.sub.2 can be removed.
[0067] A real placenta may be used (ex vivo human placenta
perfusion model) for oxygenation, dialyzation and nutritioning. In
case of a real placenta, the grey block "artificial placenta
circulation" in FIGS. 3 and 4 may have an alternative text "real
placenta circulation". The placenta might be a priory prepared
donor placenta, to guarantee a smooth and quick transition from
intra-uterine to the artificial womb environment, but ideally the
placenta would be of the biological mother of the fetus (if
healthy). The placenta might be replaced later by an artificial
placenta. The placenta will use a separate circulation circuit with
preferably maternal blood. This circulation is connected to an
adult ECMO (this is similar to "O.sub.2 meter" and "gas mixer" with
gas bottles as presented in center of FIGS. 1 and 5), to provide
for physiologic flow rates and blood values (CO.sub.2 and O.sub.2),
but also to adult dialyzation, to ensure metabolic waste removal of
the blood that exits at the maternal side of the placenta (similar
to "dialyzer" and "filter" with "dialyzer fluid drain/treated with
water" as presented in FIGS. 1 and 5). Nutrition compounds are
applied through total parenteral nutrition, inserted to the blood
that enters the maternal side of the placenta (This can be seen in
all corresponding figures as "IV fluids and medications").
[0068] FIG. 5 shows a schematic view of the system for incubation
according to the invention. This illustrates the infant in a safe
environment, and shows that the monitoring and cardiorespiratory
needs are not interfering with the infant. The infant is supplied
with oxygen, nutrients, heat and amniotic fluid; and waste and
carbon dioxide are washed out via an extra-corporeal life support
and an artificial placenta, without changing the fetal
cardiorespiratory circulation.
DESCRIPTION OF EMBODIMENTS
[0069] In an embodiment of the system according to the present
invention, the amniotic fluid circulation unit further comprises a
UV light source the membrane purification system.
[0070] In another embodiment, the amniotic fluid circulation unit
comprises one or more sensors arranged for purification of said
amniotic fluid.
[0071] In another embodiment, the amniotic fluid circulation unit
further comprises an inlet port to introduce nutrients and water
into the amniotic fluid.
[0072] In another embodiment, the system further comprises one or
more stimulation devices inside or attached to the outer chamber.
In a specific embodiment, the one or more stimulation devices
comprise one or more of the group of: auditory stimulation devices,
visual stimulation devices and tactile stimulation devices.
[0073] Examples of auditory stimulation include family sounds such
as speech, sungs, household sounds (e.g. playing music, family
interactions); and maternal physiological sounds such as bowel
sounds and heartrate. The auditory stimulation device can comprise
audio speakers.
[0074] Examples of visual stimulation include light and darkness
for mimicking a diurnal rhythm. The visual stimulation device can
comprise controlled lighting.
[0075] Examples of tactile stimulation include maternal movements
such as walking, sporting, sitting and lying, but also breathing;
uterine contractions such as Braxton Hicks contractions during
"incubation time" or labor contractions prior to transition from
the artificial womb to neonatal life.
[0076] In another embodiment, the system further comprises one or
more sensors inside or attached to the outer chamber. In a specific
embodiment, the one or more sensors comprise microfluidic device
and/or a capacitive sensor. In an embodiment, the one or more
sensors are chosen from the group of a camera, ultrasound imaging
device, electrocardiograph (ECG), electroencephalograph (EEG),
tactile sensor device, chemical analysis device for blood and/or
amniotic fluid, and combinations thereof.
[0077] In another embodiment, the system further comprises an extra
corporeal membrane oxygenation unit (ECMO).
[0078] In another embodiment, the system further comprises an inlet
port assembly for fluids, arranged for connecting with the
umbilical cord of said infant.
[0079] In an embodiment one or more elements of the system are
computer-implemented. The system may comprise a processor, a memory
system and/or a controller for operating the system according to
the invention. A computer program may be stored/distributed on a
suitable medium, such as an optical storage medium or a solid-state
medium supplied together with or as part of other hardware, but may
also be distributed in other forms, such as via the Internet or
other wired or wireless telecommunication systems. A single
processor or other unit may fulfil the functions of several items
recited in the claims.
[0080] Other variations to the disclosed embodiments can be
understood and effected by those skilled in the art in practicing
the claimed invention, from a study of the drawings, the
disclosure, and the appended claims. In the claims, the word
"comprising" does not exclude other elements or steps, and the
indefinite article "a" or "an" does not exclude a plurality. The
mere fact that certain measures are recited in mutually different
dependent claims does not indicate that a combination of these
measured cannot be used to advantage. Any reference signs in the
claims should not be construed as limiting the scope thereof.
[0081] The scope of the present invention is defined by the
appended claims. One or more of the objects of the invention are
achieved by the appended claims.
* * * * *